I wrote a version of this on Facebook recently, but I thought it would be good to tweak it a bit and repost it here, for better archiving and for better context.
I want to talk about the difference between a panic attack and an anxiety attack, at least when I talk about them.
A panic attack is sudden, a massive flip of the fight-or-flight switch, usually triggered by something. It comes with hyperventilating, a feeling of total loss of control, terror of the world around me, a gripping fear that I might be having a heart attack, and tears. Regulating my breathing and distracting myself with things that are calming and/or intellectually intriguing and/or funny can help calm me down. Xanax also helps A LOT. Panic attacks rarely last more than 30 minutes for me, but they’re terrifyingly intense.
Anxiety attacks are much less intense but in a lot of ways, they’re much worse, and as far as I can tell, they’re usually not triggered by anything I can identify. They usually build up slowly and come with a fairly low-level but persistent feeling of unease, fear, and a constant worry that something “bad” could happen at any minute. There’s also sweating and a frequent shift between feeling too cold and too warm, increased emotional sensitivity, and an excess of energy that I don’t know what to do with (leading me to clench my fists or wring my hands and tap my feet a lot)*. Anxiety attacks can last for hours or, even worse, days. Regulating my breathing or taking deep breaths doesn’t help. Unlike with a panic attack, I can hide the anxiety attack, make jokes, be friendly and polite, express myself fairly coherently…but like piranha-infested waters, the anxiety is constantly swimming around me, threatening to devour me. Xanax can help calm me down, but it’s no guarantee that it will dispel the attack for good. If I can get away from work and other responsibilities for a while, I can take a larger dosage of Xanax (a whole milligram!) and knock myself out for a few hours, which does generally dispel the anxiety.
Seeing someone have a panic attack can be unnerving, but there are things people can do to help: remind me to slow and regulate my breathing, distract me with jokes or shift my attention away from myself and onto something else, and, if appropriate under the circumstances, hold me.
Unfortunately, there isn’t much people can do to help against anxiety attacks beyond being sympathetic, not asking what triggered it, not giving advice on how to deal with it, giving me space to deal with it on my own, and, if appropriate under the circumstances, holding me. (Basically, hugs and hand-holding are always welcome.)
* The feeling of too much energy makes me wonder if my anxiety attacks are connected to my ADHD. I have this idea that if I can figure out ways to focus that energy into something positive, I can help change the anxiety attacks from something that makes me feel weak and not in control to something that makes me feel strong and in control. I think ADHD is one of my superpowers, maybe even the source of all of my superpowers, so if these anxiety attacks are a side effect of that, I want to turn them into another superpower.